Anthony D. Panzera

Adolescent Asthma Self-Management: Patient and Parent-Caregiver Perspectives on Using Social Media to Improve Care.

BACKGROUND Self-management of asthma can now leverage new media technologies. To optimize implementation they must employ a consumer-oriented developmental approach. This study explored benefits of and barriers to improved asthma self-management and identified key elements for the development of a digital media tool to enhance asthma control. METHODS Between August 2010 and January 2011, 18 teens with asthma and 18 parent-caregivers participated in semistructured in-depth interviews to identify mechanisms for improving asthma self-management and propose characteristics for developing a digital media tool to aid such efforts. RESULTS Teens and caregivers enumerated physician-recommended strategies for asthma management as well as currently employed strategies. Both groups thought of a potential digital media solution as positive, but indicated specific design requirements for such a solution to have utility. Whereas most participants perceived mobile platforms to be viable modes to improve asthma self-management, interest in having social networking capabilities was mixed. CONCLUSIONS A digital media product capable of tracking conditions, triggers, and related asthma activities can be a core element of improved asthma control for youth. Improved asthma control will help decrease school absenteeism.

Community-Based Prevention Marketing for Policy Development A New Planning Framework for Coalitions

Community-based prevention marketing (CBPM) is a community-driven framework for program planning, which applies social marketing concepts and techniques to the development of health behavior interventions. Whereas community members who comprise an action committee or coalition set the goals and make programmatic decisions, social marketing provides the planning framework to guide program design, implementation, and evaluation. CBPM has guided successful initiatives to promote physical activity in both youth and adults, to increase safety eyewear use in agricultural settings, and to delay alcohol and tobacco initiation among youth. However, the emergence of evidence-based policy has fostered renewed interest in “upstream” approaches to health behavior change that, in the United States, have included community partnerships as an important tool for policy development. Unfortunately, these community partnerships have had variable success because of the lack of a systematic framework for identifying, selecting, tailoring, and promoting evidence-based policies. We describe the adaptation and application of CBPM to improve community capacity for identifying and promoting evidence-based policies. The resulting framework, CBPM for Policy Development, is comprised of the following eight steps: (1) build a strong foundation for success; (2) review evidence-based policy options; (3) select a policy to promote; (4) identify priority audiences among beneficiaries, stakeholders, and policy makers; (5) conduct formative research with priority audiences; (6) develop a marketing plan for promoting the policy; (7) develop a plan for monitoring implementation and evaluating impact; and (8) advocate for policy change. We provide a description of each step and an examination of the experiences and lessons learned in applying it to youth obesity prevention.

Applying Systems Science to Evaluate a Community-Based Social Marketing Innovation A Case Study

In the United States, community coalitions are an important part of the public health milieu, and thus, subject to many of the same external pressures as other organizations—including changes in required strategic orientation. Many funding agencies have shifted their funding agenda from program development to policy change. Thus, the Florida Prevention Research Center created the Community-Based Prevention Marketing (CBPM) for Policy Development framework to teach community coalitions how to apply social marketing to policy change. The research reported here was designed to explicate the framework’s theory of change. We describe and demonstrate a hybrid evaluation approach: utilization-focused developmental evaluation. The research question was “What are the linkages and connections among CBPM inputs, activities, immediate outcomes, intermediate outcomes, and ultimate impacts?” We implemented a case study design, with the case being a normative community coalition. The study adhered to a well-developed series of steps for system dynamics modeling. Community coalition leaders may expect CBPM to provide immediate gains in coalition performance. Results from causal diagramming show how gains in performance are delayed and follow an initial decline in performance. We discuss the practical implications for CBPM’s developers—for example, importance of managing coalition expectations—and other social marketers—for example, expansion of the evaluation toolkit.

Physicians’ perceptions of mobile technology for enhancing asthma care for youth:

This study assessed physicians’ receptivity to using mobile technology as a strategy in patient care for adolescents with asthma. Understanding physicians’ perceived barriers and benefits of integrating mobile technology in adolescents’ asthma care and self-management is an initial step in enhancing overall patient and disease outcomes. We conducted in-depth interviews with second- and third-year pediatric residents and attending physicians who oversee pediatric residents in training (N = 27) at an academic medical center in the southeastern United States. We identified both benefits from and barriers to broader use of mobile technologies for improving asthma outcomes in adolescents. Resident physicians demonstrated greater readiness for integrating these technologies than did attending physicians. Prior to adoption of mobile technologies in the care of adolescent asthma patients, barriers to implementation should be understood. Prior to widespread adoption, such systems will need to be evaluated against traditional care for demonstration of patient outcomes that improve on the current situation.

Social Marketing and Policy Making: Tools for Community-Based Policy Advocacy

The Florida Prevention Research Center (FPRC) at the University of South Florida has been funded by the U.S. Centers for Disease Control and Prevention (CDC) since 1998. In that time, its staff of researchers and practitioners have codeveloped with its community partners a wealth of tools for using social marketing to address local problems. Similar to the field of social marketing, the FPRC is evolving from exclusively developing ‘‘downstream’’ innovations to working farther ‘‘upstream,’’ which means we are frequently developing and testing new types of tools for those purposes. In this ‘‘Tools from the Field’’ paper, we share some tools and lessons learned for carrying out social marketing with community coalitions as well as preview forthcoming tools emanating from our latest CDC-funded research.

Mapping a WIC Mother’s Journey: A Preliminary Analysis

While the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides numerous benefits to many enrolled families across the United States, including access to nutritious foods, some recent drops in maternal participation in Kentucky resulted from failures to retrieve those benefits. We explored perceived benefits of and encountered barriers to food benefit retrieval. Journey mapping included direct observations of client appointments, clinic lobby areas, and a shopping experience and was augmented with focus groups conducted in two urban and two rural areas. Major touchpoints before WIC appointments, during those appointments at clinics, and after appointments when redeeming food benefits were identified. Across touchpoints, mothers identified childcare, transportation issues, long waits, confusion regarding eligibility, problems scheduling appointments, and stigma as barriers to their ability to retrieve food instruments. Despite these barriers mothers value the benefits of WIC, especially access to healthy foods, infant formula, and nutrition education. This work demonstrates a method by which WIC mothers’ experiences shed light on client service shortfalls and possible opportunities to improve client services.